Journal of Health Research and Reviews (in Developing Countries)

REVIEW ARTICLE
Year
: 2019  |  Volume : 6  |  Issue : 1  |  Page : 1--4

Is coconut oil good for oral health? A review


Faizal C Peedikayil 
 Department of Pedodontics and Preventive Dentistry, Kannur Dental College, Kannur, Kerala, India

Correspondence Address:
Prof. Faizal C Peedikayil
Department of Pedodontics and Preventive Dentistry, Kannur Dental College, Kannur, Kerala
India

Abstract

Oral health is considered to be of prime importance to all individuals in maintaining good health, and the accepted method of oral hygiene maintenance is mechanical method of tooth cleaning. At present, chemotherapeutic agents are also used as adjutants to reduce plaque formation, but they have their own disadvantage. This has paved the way for the use of natural and plant derivatives as alternatives for chemotherapeutics in dentistry. Coconut oil is considered as a tree of life in ancient literature and is used for any ailments. Coconut oil is edible and is consumed as a part of the staple diet in many countries. It also has medicinal and cosmetic properties. Coconut oil differs from most other dietary oils because of the high content of medium chain fatty acid (MCF), whereas in the majority of other oils, the basic building blocks are almost entirely long chain fatty acids. The MCF in coconut oil such as lauric, caproic, caprylic, myristic, and stearic acid influences the physical and chemical properties. Lauric acid, which is predominant in coconut oil, has proved to have antimicrobial, antiviral, and anti-inflammatory action. Of late, few studies have been conducted by researchers regarding the action of coconut oil on oral health. The review of literature shows excellent results on the use of coconut oil on oral health. This short review discusses the studies conducted on coconut oil on oral microorganisms and anti-inflammatory actions.



How to cite this article:
Peedikayil FC. Is coconut oil good for oral health? A review.J Health Res Rev 2019;6:1-4


How to cite this URL:
Peedikayil FC. Is coconut oil good for oral health? A review. J Health Res Rev [serial online] 2019 [cited 2022 Sep 26 ];6:1-4
Available from: https://www.jhrr.org/text.asp?2019/6/1/1/257477


Full Text



 Introduction



Coconut oil is growing in popularity as functional food oil, and the public awareness of it is increasing. It is expected that the use of coconut oil will experience a dramatic growth in the market as people are looking for natural alternatives for chemotherapeutic agents. Although coconut oil has been used for many ailments from the ancient times and traditional medicine, the introduction of virgin coconut oil in the market has open up new research on its anti-inflammatory, antibacterial, and antiviral effects. This review discusses the available literature about coconut oil on oral health.[1]

Coconut oil is edible oil that is easily available and predominantly composed of medium chain fatty acids (MCFs). According to the Ayurvedic literature, coconut oil nourishes the body and helps in increasing the resistance against diseases.[1] The use of the medicated coconut oil with herbs is a common practice among the people of South India. It is said that coconut oil preparations promote hair growth and protect the skin from various infections. The use of coconut oil in dietary as well as nourishment is common in coconut-growing countries.[2]

Coconut oil contains lot of MCFs such as lauric acid, caprylic acid, myristic acid, capric acid, linoleic acid, oleic acid, stearic acid, and palmitic acid. Lauric acid constitutes majority of MCFs in coconut oil. These MCFs are similar to MCFs in mother's milk and have similar beneficial effects.[3]

The present paper is aimed to discuss the studies conducted on coconut oil on oral microorganisms and anti-inflammatory actions on oral health.

 Coconut Oil Swishing



Coconut oil pulling or oil swishing therapy is a traditional procedure in which the person rinses the oil in their mouth for the prevention of dental diseases. Oil pulling is mentioned in ancient Ayurveda textbooks like Charaka Samhita and Arthashastra and is referred to as Kavala Gandoosha and Kavala Graha. Kavala Gandoosha is a procedure in which the mouth is completely filled with large amount of oil so that gargling is impossible and is spitted after few minutes, whereas Kavala Graha is a procedure in which the oil is retained in the mouth and gargled.[4] Some Ayurveda textbooks say that oil pulling cures about 30 systemic diseases and regular use can slow down aging process.[5]

This method came into the limelight in recent literatures after an Ukranian doctor, Dr. F. Karach presented a conference paper explaining the healing process that can arise from oil pulling using edible oils. Thereafter, researchers from all over the world started turning their attention to this method. Oil pulling is advised to be done in the morning on empty stomach, the oil is taken in the mouth and is also pulled between the teeth for few minutes till the oil turns thin and milky white and is spitted and should be followed by tooth brushing.[4] A variety of common edible oils are used for oil pulling therapy such as sesame oil, coconut oil, sunflower oil, groundnut oil, olive oil, mustard oil, and leaf extracts of gooseberries and mango. The advantage of these natural oils is that they neither cause any staining as seen in use of chlorhexidine mouthwashes nor there is any after taste or allergic reactions and is readily available.[4]

 Oral Anti-Microbial Properties of Coconut Oil



The antimicrobial effect of coconut oil was first reported by Hierholzer and Kabara.[6] Recent studies show that coconut oil has antimicrobial activity against a spectrum of organisms such as Escherichia vulneris, Enterococcus spp, Helicobacter pylori, Staphylococcus aureus, Candida albicans, and other strains due to the presence of monolaurin, a monosaccharide in coconut oil.[5]

Oral cavity is a natural habitat for various microorganisms causing dental caries, periodontal diseases, halitosis, etc., Streptococcus mutans, Lactobacilli, and C. albicans are the microorganisms predominantly found in dental plaque associated with a caries lesion.[7]

Recently, few studies have reported action of coconut oil on S. mutans. In Athlone Institute of Technology, Ireland, a study was conducted to find the antibacterial action of coconut oil with certain enzymes. The oils were tested against Streptococcus bacteria which are common inhabitants of the oral cavity. The study confirms that enzyme-modified coconut oil strongly inhibited the growth of most strains of streptococcus bacteria including S. mutans.[8]

The effect of oil pulling using coconut oil, corn oil, rice bran oil, palm oil, sesame oil, sunflower oil, and soya bean oil was studied by Thaweboon et al.[6] on the biofilm models formed by S. mutans, C. albicans, and Lactobacillus casei. It was found that coconut oil exhibited antimicrobial activity against S. mutans and C. albicans.

Peedikayil et al.[9] conducted a study on fifty female children aged 8–12 years to compare the coconut oil pulling with chlorhexidine mouthrinse. The participants were asked to routinely perform oil swishing with coconut oil or chlorhexidine and rinse every morning after brushing for 2–3 min for 30 days. S. mutans counts in plaque and saliva were determined using Dentocult SM Strip Mutans test on day 1, day 15, and day 30. The results showed that there is a statistically significant decrease in S. mutans. Count in coconut oil group as well as chlorhexidine group from baseline to 30 days which denotes that coconut oil pulling as the same efficacy as chlorhexidine gargle in reducing the S. mutans count.

A randomized controlled study done by Kaushik et al.[10] on 60 individuals evaluated the effect of coconut oil pulling on the S. mutans count in saliva and compared its efficacy with that of chlorhexidine and showed that there is a significant reduction of S. mutans in both groups as in previous studies. Singla et al.[11] in a study assessed the reduction in S. mutans and Lactobacillus species count in saliva sample after oil gum massage therapy daily for 3 weeks with sesame oil, olive oil, and coconut oil and found that there was a significant reduction in S. mutans count and Lactobacillus count, in all four groups after the study.

A recent randomized controlled concurrent parallel, triple-blinded clinical trial by Pavithran et al.[12] studied the effect of oil pulling therapy with coconut oil on S. mutans count. They also compared its efficacy against sesame oil and saline. The results showed that there is a statistically significant reduction in S. mutans colony-forming unit count after oil pulling with pure coconut oil even though there was no statistically significant difference between sesame oil and coconut oil.

Monolaurin and other medium chain monoglycerides present in coconut oil are shown to have the ability to alter microbial cell walls, cell membrane penetration, and destruction and inhibit the enzyme production, leading to the death of the bacteria.[3],[9] Electron microscopic image showed that 15 min exposure to monolaurin, a monosaccharide present in coconut oil, caused cell shrinkage and cell disintegration of Gram-positive cocci.[13]

Candida is normal commensal in the oral cavity of healthy individuals. The percentage of Candidal colonization ranges from 20% to 40% in healthy individuals. There are many species of Candida, of which C. albicans is the most prevalent in the oral cavity. The presence of C. albicans in the oral cavity is found to enhance its pathogenicity of S. mutans.[14],[15]

The caprylic acid which is present in coconut oil is the most effective of the fatty acids in fighting Candida. It works by penetrating the cell walls of the Candida, leading to its rupture by inhibition of growth and eventually destroying it. Capric and lauric acids are also active in inhibition of C. albicans and may therefore be useful for the treatment of infections caused by that pathogen or others that infect the skin and mucosa, possibly in conjunction with antibiotic therapy over a longer period of time. Capric acid, a 10-carbon saturated fatty acid, causes the fastest and most effective killing of C. albicans, leaving the cytoplasm disorganized and shrunken because of a disrupted or disintegrated plasma membrane. Lauric acid, a 12-carbon saturated fatty acid, is the most active MCFs at lower concentrations.[16]

In a study done in Ibaden Nigeria[17] on antimicrobial properties of coconut oil on candida species, it has been found that coconut oil was active against Candida species at 100% concentration compared to fluconazole.

In a significant study by Shino et al.,[7]Candida species were isolated from children with early childhood caries and studied the antifungal effect of coconut oil on C. albicans in comparison with chlorhexidine and ketoconazole. The study showed that chlorhexidine and coconut oil have shown significant antifungal activity which is comparable with ketoconazole which is an antifungal agent.

 Oral Anti-Inflammatory Properties of Coconut Oil



The accumulation of dental plaque is considered to be the primary cause for gingival inflammation. Dental plaque is defined clinically as a structured and resilient substance that can attach to hard surfaces and is mainly composed of bacteria in a matrix of salivary glycoprotein and extracellular polysaccharides. Plaque-induced gingivitis is the result of an interaction between plaque and the tissues and the host inflammatory response.[18],[19]

Studies have shown that coconut oil pulling reduces the plaque accumulation and gingivitis associated with it. Peedikayil et al.[20] in a significant study evaluated the effect of coconut oil pulling/oil swishing on plaque formation and plaque-induced gingivitis in 60 age-matched boys and girls in the age group of 16–18 years with plaque-induced gingivitis. Plaque and gingival indices of the subjects were assessed at baseline days 1, 7, 15 and 30. The results show that there is a statistically significant decrease in the plaque and gingival indices from day 7 and the scores continued to decrease during the period of study and concluded that coconut oil swishing could be an effective adjuvant procedure in decreasing plaque formation and plaque-induced gingivitis.

Studies by Singla et al.[11] found that mouth gum massage therapy with coconut oil reduces the plaque and gingival scores and is comparable with chlorhexidine.

A recent study done to compare the effect of coconut oil pulling practice with oil pulling using sesame oil in plaque-induced gingivitis found that there is a significant reduction in the severity of gingivitis in both groups at the 7th, 14th, and 21st days. Comparison between the coconut oil and sesame oil group also revealed a more significant reduction in the severity of gingivitis in coconut oil group than the sesame oil group at all postintervention stage. Nagilla et al.[21] in a randomized controlled study evaluated antiplaque efficacy of coconut oil pulling with a placebo; the results showed a significant reduction of plaque scores by coconut oil pulling.

The decrease of plaque-related gingivitis due to oil pulling can be attributed to decreased plaque accumulation on tooth surface and also the anti-inflammatory and emollient action of coconut oil. Peedikayil et al.[20] in a study showed that coconut oil pulling as an adjuvant procedure helps in decreasing the plaque and gingival index. In coconut oil pulling, as the oil is swished in the mouth and the mechanical shear forces exerted on the oil leads to emulsification of the oil and the surface area of the oil is increased considerably.[4] The film of oil thus formed on the tooth surface and the gingiva can reduce plaque adhesion and bacterial aggregation. It was also proposed by some researchers that the alkalis in the saliva may react with MFAs in the coconut oil leading to saponification and formation of soap like substance which can reduce the adhesion of plaque. The soaps produced with coconut oil can form lather and have an increased cleansing action. The lauric acid in the coconut oil can easily react with sodium hydroxide in saliva during oil pulling to form sodium laureate, which is the main constituent of soap responsible for the cleansing action and decreased plaque accumulation.[20],[22]

 Conclusion



Currently, the scientific bodies do not recommend coconut oil for oral health due to lack of evidence. More researches and clinical trials have to be conducted to change the perception. The scientific explanations for the beneficial effects of coconut oil will come a long way in substituting the chemotherapeutic materials available in the market. More studies have to be conducted to find the exact mechanism of action of the contents of coconut oil.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

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